Evidence map›Paper›PMID 42399686›Full record

Trial reportNutrition & diabetes2026

Subgroup-specific cardiovascular effects of intensive lifestyle intervention: a causal forest analysis in adults with type 2 diabetes and overweight/obesity.

Xingfeng Xu, Jiangjie Lei, Lixiang He, Juntao Zheng, Peng Wang, Yue Guo, Menghui Liu, Xiaodong Zhuang, Xinxue Liao

Abstract readRandomized Controlled Trial
In one paragraph

Trial report in Nutrition & diabetes, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors.

Xingfeng Xu *Department of Cardiology, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China.ORCID http://orcid.org/0000-0002-8026-2128
Jiangjie Lei *Department of Cardiology, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China.
Lixiang He *Department of Cardiology, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China.ORCID http://orcid.org/0000-0002-8196-5183
Juntao ZhengDepartment of Cardiology, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China.
Peng WangDepartment of Cardiology, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China.
Yue GuoDepartment of Cardiology, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China.
Menghui LiuDepartment of Cardiology, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China. liumh58@mail.sysu.edu.cn.ORCID http://orcid.org/0000-0001-6021-4447
Xiaodong ZhuangDepartment of Cardiology, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China. zhuangxd3@mail.sysu.edu.cn.
Xinxue LiaoDepartment of Cardiology, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China. liaoxinx@mail.sysu.edu.cn.

Funding

National Natural Science Foundation of China (National Science Foundation of China) 82370358National Natural Science Foundation of China (National Science Foundation of China) 82400495National Natural Science Foundation of China (National Science Foundation of China) 82470361
6 · The paper itself

Abstract

objectiveTo evaluate the heterogeneity of treatment effects (HTEs) of intensive lifestyle intervention (ILI) in adults with type 2 diabetes and overweight/obesity, and identify a subgroup with greater cardiovascular benefits from ILI.

methodsIn a post-hoc analysis of the Look AHEAD trial, causal forest modeling was used to identify HTEs of ILI. The study population was stratified into four subgroups, and the associations of ILI with cardiovascular outcomes were assessed using multivariable Cox modeling compared to diabetes support & education (DSE).

resultsAmong 4710 participants (mean age 58.9 years, 58.5% women), 768 primary outcomes occurred over a median follow-up of 9.5 years. Key variables identified through causal forest modeling were SF-36 mental health, diabetes duration, and urine albumin-creatinine ratio (ACR). In Subgroup 4 (SF-36 mental health > 55.64 and ACR > 10 mg/g), which had more cardiovascular risk factors and comorbidities, ILI significantly reduced the primary outcome risk (HR: 0.65, 95% CI: 0.48-0.87, P = 0.004) and three secondary outcomes compared to DSE. No cardiovascular benefits were observed in participants with SF-36 mental health ≤ 55.64 or ACR < 10 mg/g.

conclusionThis post-hoc analysis of the Look AHEAD trial showed HTEs of ILI in adults with type 2 diabetes and overweight/obesity. Participants with better mental health, poorer renal function, and more cardiovascular risk factors were more likely to benefit from ILI.

Indexed as

Cardiovascular DiseasesDiabetes Mellitus, Type 2Life StyleObesityOverweightAgedFemaleHeart Disease Risk FactorsHumansMaleMiddle AgedTreatment Effect Heterogeneity

Identifiers

PMID42399686
PMCPMC13601546

What Socratic holds

Textmetadata
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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.